HUMANITIES | ENCOUNTERS Is this hair professional enough? n Cite as: CMAJ 2021 February 16;193:E254-5. doi: 10.1503/cmaj.201871 was eight years old when my mother sent me to school with Bantu knots in my hair. This hairstyle, which origi- Inated with the Zulu people of southern Africa, was worn for centuries on the Afri- can continent before becoming widely adopted by the diaspora. I returned home that afternoon in tears. My classmates, unaccustomed to a hairstyle of that sort, had spent all day laughing, pointing and comparing my hair to excrement. The tiny shred of pride I had had in my natural kinky-textured hair was crushed. I told my mother never to style it like that again and begged her for a chemical hair relaxer; she finally caved in about two years later. I spent the ensuing years, into early adulthood, chemically straightening my hair and adopting a variety of protective styles: braids, cornrows, hair extensions and wigs. Women of African descent com- monly use these styles to protect our hair from overmanipulation and to permit undisrupted growth of the hair. Unfortunately, these styles, along with the use of chemical relaxers for perma- nent hair straightening, have been strongly linked to a form of hair loss known as traction alopecia. One study found that a third of Black women suffer from this condition, which can lead to Image copyright iStock.com/GeorgePeters. No standalone file use permitted. permanent hair loss if not detected and treated early.1 In addition, Black women women in my environment, I subscribed The end of my undergraduate degree who use relaxers have been shown to to that belief and happily shelled out hun- and the beginning of my journey in medi- have a higher likelihood of developing dreds of dollars in pursuit of these looks. cine coincided with this period of celebra- uterine fibroids.2 The early 2000s saw a resurgence of tion of natural Black hair. After contem- There is a general knowledge of the the “natural hair movement” in Black plating going natural for a while, I harm caused by these practices, but not communities around the globe. It origi- ultimately relaxed my hair again a few much has been done to raise awareness nated during the Black Power movement weeks before my first semester of medical on the topic in Black communities. In fact, of the 1960s, and uplifts and encourages school. Despite feeling inspired by the it is often implied that in order to attain a people of African descent to wear their hair natural hair movement and aware of the certain level of professional and societal in its naturally wavy, curly or coiled state. dangers of chemical relaxers, I was still success, Black women must conform to YouTubers and natural-hair bloggers were convinced that my straight hair and Eurocentric standards of beauty by opting instrumental in bringing to the masses the extensions were more acceptable for a for straightened hairstyles over natural, tools and information needed to properly medical setting and would allow me to Afro-textured ones.3 Like most Black care for and style Afro-textured hair. blend in as much as possible. E254 CMAJ | FEBRUARY 16, 2021 | VOLUME 193 | ISSUE 7 © 2021 Joule Inc. or its licensors Two years into medical school, after these have led to the drafting of the the appearance of trainees must be HUMANITIES numerous painful and costly braiding ses- CROWN Act: Create a Respectful and Open updated accordingly. Drafters of dress sions and weave installations, I finally World for Natural Hair. It is currently law in codes should be mindful of their potential decided to go for the “big chop”: all the seven American states and prohibits dis- to perpetuate biases that implicitly centre relaxed ends were cut off, leaving only crimination based on hairstyles and hair whiteness, while disproportionately natural, unprocessed hair. I planned this texture.5 Similar initiatives are needed penalizing people of colour. Antidiscrimi- cut to coincide with my summer vacation elsewhere. nation policies should consider traits his- so as to avoid intrusive comments from Now, as a fourth-year medical student torically associated with race and culture, colleagues about the drastic change. It with residency interviews around the cor- such as hairstyle and texture, as prohib- was freeing to let go of those damaged ner, I cannot help but ponder how my ited grounds of discrimination. It is time strands and embrace my short, tightly image will be perceived by potential for the governing bodies of medicine to coiled locks for the first time. After admissions committees. I’ve read stories redefine professionalism in a way that not ten years of wearing hair extensions and of Black physicians who maintained only includes but also celebrates the chemically altering the texture of my hair, straightened hairstyles until completing diverse backgrounds, identities and val- I had forgotten what my natural hair truly residency; only then would they allow ues present among today’s physicians. looked like. themselves to explore natural styles. I’ve When fall came, my newfound hair- heard of candidates who purposefully Samantha Bizimungu BScKin style was met with compliments and wore hair extensions on interview day to Faculty of Medicine, Université de innocent curiosity by my peers. At the maintain a professional image. While Montréal, Montréal, Que. start of clerkship, however, I had qualms acknowledging that these are personal about whether my short Afro hair would choices and not strictly the product of References be deemed professional enough for a clin- outside influence, we cannot deny that 1. Loussouarn G, El Rawadi C, Genain G. Diversity ical setting. On several occasions when I the culture of medicine has contributed of hair growth profiles. Int J Dermatol 2005; 44(Suppl 1):6-9. was mistaken for a nurse, an orderly or a to Black trainees’ reluctance to let their janitor, I asked myself if — on top of my hair be natural in professional settings. 2. Wise LA, Palmer JR, Reich D, et al. Hair relaxer use and risk of uterine leiomyomata in African- visibly Black skin — my hairstyle did not Throughout our medical training, we American women. Am J Epidemiol 2012;175:432-40. fit with society’s image of a doctor-to-be. are taught, implicitly and explicitly, to 3. Bankhead T, Johnson T. Self-esteem, hair- My experience is, luckily, far from the tone down our individuality in favour of esteem and Black women with natural hair. Int J worst. A 2018 study found that hair was a adopting a more neutral, standardized Educ Soc Sci 2014;1:92-102. common theme associated with microag- image. But this image is the product of a 4. Osseo-Asare A, Balasuriya L, Huot SJ, et al. Minority resident physicians’ views on the role of gressions experienced by minority resi- bygone era when physicians were an race/ethnicity in their training experiences in the dent physicians in the workplace.4 The exclusive group, mostly homogeneous in workplace. JAMA Netw Open 2018;1:e182723. United States Army made headlines in race and gender. People of colour who 5. The CROWN Act [main page]. Available: www. 2014 when its new grooming policy for- have since integrated into the field of thecrownact.com (accessed 2020 July 7). mally banned hairstyles such as Afros, medicine feel obligated to divest them- This article has been peer reviewed. braids and cornrows (www.huffingtonpost selves of their cultural identity so as to Content licence: This is an Open Access article .ca/entry/army-hairstyle_n_5070180 ?ri18n adapt to this predominantly White space. distributed in accordance with the terms of the =true). In 2013, a seven-year-old girl in Fortunately, a growing number of Black Creative Commons Attribution (CC BY-NC-ND Tulsa, Oklahoma, was sent home from physicians are beginning to change this 4.0) licence, which permits use, distribution and school because her dreadlocks were culture by unapologetically donning their reproduction in any medium, provided that the deemed a distraction for her classmates natural hair in the workplace. original publication is properly cited, the use is noncommercial (i.e., research or educational (www.today.com/parents/school-barred-7 As our medical education system shifts use), and no modifications or adaptations are -year-olds-dreadlocks-changes-dress-code toward being more inclusive, the formal made. See: https://creativecommons.org/ -policy-8C11122821). Instances such as policies and unspoken rules that govern licenses/by-nc-nd/4.0/ CMAJ | FEBRUARY 16, 2021 | VOLUME 193 | ISSUE 7 E255.